Emily Oster, an economist at Brown University who writes about parenting frequently, published an article in The Atlantic in March that angered a lot of people. The title was, “Your Unvaccinated Child Is Like a Vaccinated Grandmother.” The article argued that COVID-19 in children is mild enough that vaccinated parents may feel comfortable going out into the world with their unvaccinated children.
Critics called the article insensitive and misleading, saying it understated the risks that children could both get sick and spread the virus. Oster responded with a note on his website with his main argument, but specifically apologized for the lack of specifics of the title. His critics seemed somewhat right.
Seven months later, with so much Covid data available, the debate on the article looks quite different.
Oster is one that has been largely upheld. If anything, later data indicates that she did not go too far in describing the age skewness of Covid. Today, an accurate version of her title might be: “Your unvaccinated child is much safer than a vaccinated grandmother.”
I agree this may sound hard to believe, so let’s take a look at some statistics. Here are hospitalization rates by both age and vaccination status in King County, Wash., which includes Seattle and releases some of the most detailed COVID data in the country:
As you can see, the risks for non-vaccinated children look similar to the risks for those vaccinated in their 50s.
England’s nationwide figures show an even greater age skew. Children under the age of 12 (a group paired with teenagers in this next chart) appear to be at lower risk in their 40s if not 30s than those who are vaccinated.
“Covid is a threat to children. But this is not an extraordinary threat,” said Dr. Alasdair Munro, a pediatrician at the University of Southampton. written. “It’s very common. In general, the risks of getting infected are similar to other respiratory viruses that you probably don’t think about much.”
danger to the elderly
There is clearly some disturbing news in these comparisons. For older people – particularly the very old, as well as those with serious health conditions – vaccination does not reduce the risk of hospitalization or death from COVID to almost zero. This differs from what early vaccine data suggest.
To be clear, getting vaccinated is still the best thing an elderly person can do. In terms of risk reduction, a vaccine is more valuable to an older adult than a young adult. Just compare the size of the bars in the above chart. Nevertheless, the COVID risks for vaccinated elderly people remain real.
David Wallace-Wells has argued in New York Magazine that despite widespread discussion of the outsized impact of COVID on the older, most people are “grossly underestimating” how big the age skew really is.
Different elderly people will respond to risks in different ways, and that’s okay. Some may decide to remain extremely cautious until caseloads drop to low levels. Others – especially those without major health problems – may choose to travel, see friends, and live their lives appropriately. The risks are not zero, but they are quite low. And some parts of life carry zero risk.
As a point of comparison, the annual risk of death for all vaccinated people over 65 in Seattle this year appears to be about 1 in 2,700. An American’s annual average risk of death in an automobile accident is low — about 1 in 8,500 — but not by a different order of magnitude.
From a policy standpoint, the threat of COVID to older people argues for encouraging them to get COVID booster shots, even if it remains unclear How low is the immunity to the vaccine. The threat also argues for more workplace vaccine mandates to reduce the overall spread of the virus.
The more encouraging half of the story is at the other end of the age spectrum.
For children with serious medical conditions, the risk of severe COVID is so low that it is difficult to quantify. For children with such a condition, the risk is greater but still less than many believe. The risk of long-term covid in children – a source of fear among many parents – also appears to be very low.
This all raises a thorny question: Should young children be vaccinated? I know some readers will hold back on the mention of that question, but I think it is a mistake to consider it indescribable. There is no scientific consensus about the vaccination of children that there is about adults. It is not clear how many countries will recommend the vaccine for young children. In the US, many vaccinated parents have made the decision not to vaccinate their eligible children just yet.
The argument against doing so is that it has some rare side effects and that COVID is no more worrisome for children than some other respiratory diseases. The argument in favor is that any troubling side effect seems very rare; that there is uncertainty about the long-term effects of COVID; And that having children vaccinated can help protect everyone, by reducing transmission.
If I had young children, I would vaccinate them without hesitation. I’ve heard the same thing from many scientists, including those who understand why many parents are reluctant. (Here’s a Times Q and A on the subject.)
It seems like a close call that leans toward vaccinations for an individual child—and an easy decision for one child’s grandparent and everyone else’s grandparent. “At any age, unvaccinated people are more likely to have transmission relative to vaccinated people,” Dr. Aaron Richterman of the University of Pennsylvania told me.
What does Oster think of all this? Instead of dismissing the earlier debate, she has taken the high road on social media and in her email newsletter. Instead, she devoted a recent newsletter to reviewing the evidence about vaccines for children and COVID.
“I hope we can be ready to be a little gentle with each other,” she wrote. “Asking questions about vaccines for children or being more cautious for children than for older adults – these are reasonable approaches.”
Finally, she explained why she would vaccinate her children once they were eligible: “I don’t want them to get COVID. I’m worried about his immune-compromised grandparents. I want to avoid quarantine and keep them in school.”
other big stories
If you think Covid restrictions are tough on land, try going on a cruise, Katrina Gulliver writes in the Wall Street Journal.
Data-driven economic findings support a greater government role in addressing inequality, says Paul Krugman.
read in the morning
Live: Iohan Gueorguiev gained a following for a video of himself biking through remote landscapes. He died at 33.